Healthcare
Process Solutions to dramatically improve Payor and Provider outcomes.
Healthcare Use Cases
-
Standardize and digitize the entire patient intake and referral process: streamlining intake from multiple sources, accelerating verification of benefits, assessment of medical necessity, prior authorization and appeals, and ensuring full & complete pre-admission preparation.
Read the case study of a regional medical provider that realized 90% improvement in onboarding cycle time in 90 days.
READ THE CASE STUDY >
-
Manage the entire life cycle of health Plan/Benefit changes, coordinating work over disparate groups including Actuarial, Contracts & Membership, Billing, etc. and integrating with downstream systems of record.
Improved collaboration with shared view of process
Management visibility and process insights
Elimination of legacy systems
Improved productivity and quality
Read the case study from a large nationwide integrated managed care consortium.
READ THE CASE STUDY >
-
Accelerate, standardize and automate highly complex capital approval processes from business case through to purchasing.
Read the case study from a large nationwide integrated managed care consortium that automated their capital review and approval system in 1 month at half the cost of competitor products.
READ THE CASE STUDY >
-
Automating claims workflows accelerates the reimbursement process, reduces administrative burdens, and ensures consistency in adjudication. This allows providers and patients to receive quicker resolutions while minimizing errors and rework.
-
Automated prior authorization systems expedite approvals for medical procedures and services, reducing wait times and improving patient outcomes. This ensures providers can deliver timely care without manual delays.
-
Automating provider enrollment and credentialing ensures quicker onboarding of new providers while maintaining compliance. Automated tracking simplifies the process of verifying credentials and renewing licenses.
-
Automating the handling of member appeals and grievances enables faster resolution and improved tracking. It ensures all cases are processed consistently and regulatory deadlines are met.
-
Automating verification processes ensures accurate and timely information for both members and providers. This eliminates confusion, reduces errors, and enhances the member experience.
-
Automating utilization review processes helps health payors monitor healthcare service usage efficiently, ensuring services are medically necessary and align with policy guidelines.
-
Automation streamlines billing audits, ensuring claims align with contract terms and reducing the risk of overpayments or compliance issues.
-
Automating workflows for chronic disease management and care coordination allows payors to proactively support members while reducing healthcare costs.
Success Stories